| Organization Name: | LAKES SURGICARE CENTER |
| NPI Number: | 1588844237 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | G. DANIEL SHANAHAN (GOVERNANCE) |
| Mailing Address: | 9640 Commerce Rd Ste 102 Commerce Twp |
| State: | MI US |
| Postal Code: | 483824167 |
| Phone Number: | 2483603888 |
| Fax Number: | 2483630894 |
| NPI Enumeration Date: | 11/10/2007 |
| NPI Last Update Date: | 11/10/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP1100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Podiatric |
| Taxonomy Definition: | |